Diabetic major amputation in <scp>F</scp>ar <scp>N</scp>orth <scp>Q</scp>ueensland 1998–2008: What is the <scp>G</scp>ap for <scp>I</scp>ndigenous patients?

O'Rourke, Sharon; Steffen, Christina M.; Raulli, Alexandra; Tulip, Fiona

doi:10.1111/ajr.12044

Cited by 27 publications

(59 citation statements)

References 17 publications

(18 reference statements)

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“…For example, in one Australian study, Indigenous people's mean age at first LEA at 56.3 years was 14 years younger than non-Indigenous people [33], while Canadian Indigenous people's first LEA at 58 years was approximately 7 years younger [55]. Interestingly, for all Alaskan Native people with diabetes there was a significant…”

Section: Lower Extremity Amputations In Indigenous People With Diabetesmentioning

confidence: 98%

“…In urban Indigenous Australians (DRUID participants), the prevalence of PAD was 12% -about twoto three-fold increased risk compared with that seen in non-Indigenous Australians (AusDiab participants) after adjusting for other factors [11]. In a study of people with diabetes in northern Australia (Queensland) undergoing major LEA, the prevalence of PAD was significantly higher in Indigenous (38%) compared with non-Indigenous people (12%) [33].…”

Section: Management Perspective Schoen and Normanmentioning

confidence: 99%

“…Common to all publications, is the observation that Indigenous people have LEA at a younger age than non-Indigenous people [33,51,55]. For example, in one Australian study, Indigenous people's mean age at first LEA at 56.3 years was 14 years younger than non-Indigenous people [33], while Canadian Indigenous people's first LEA at 58 years was approximately 7 years younger [55].…”

Section: Lower Extremity Amputations In Indigenous People With Diabetesmentioning

confidence: 99%

“…Similarly, ESRD is frequently associated with LEA in Indigenous people with diabetes. In northern Australia, Indigenous people with prior diabetes-related amputations were significantly more likely to suffer from chronic kidney disease than comparable non-Indigenous people [33]. Indigenous Canadians with diabetes and ESRD were, on average, 7 years younger than non-Indigenous, and had a higher frequency of previous amputation, ulceration, osteomyelitis and mean number of foot ulcers, and risk of future ulceration [57].…”

Section: Management Perspective Schoen and Normanmentioning

confidence: 99%

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Diabetic foot disease in Indigenous people

Schoen

Norman²

2014

Diabetes Management

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This article will examine what is known about the epidemiology of diabetic foot disease in Indigenous people and what strategies have been used to manage the problem. The prevalence of diabetes is several-fold higher in Indigenous people compared with non-Indigenous people. The prevalence of diabetic peripheral neuropathy varies but in general it appears to be more common and start at a younger age in Indigenous compared with non-Indigenous people. Peripheral artery disease is also more prevalent and the incidence of lower extremity amputation is higher. Various strategies have been shown to be effective in the delivery healthcare for diabetic foot disease in Indigenous people. There are, however, social and political barriers to the implementation and success of these interventions.

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Section: Lower Extremity Amputations In Indigenous People With Diabetesmentioning

confidence: 98%

Section: Management Perspective Schoen and Normanmentioning

confidence: 99%

Section: Lower Extremity Amputations In Indigenous People With Diabetesmentioning

confidence: 99%

Section: Management Perspective Schoen and Normanmentioning

confidence: 99%

See 2 more Smart Citations

Diabetic foot disease in Indigenous people

Schoen

Norman²

2014

Diabetes Management

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“…In the only review of its kind, it was presented that disproportionate levels of DRLEA occurred in remote Far North Queensland areas [76]. This particular study (with 147 participants) was undertaken in a region where a higher As stated, one of the aims of this review is to ascertain the relationship of all three variables simultaneously and the impact of DFD and DRLEA (refer to Figure 2 [53].…”

Section: Australiamentioning

confidence: 99%

Socio-Economic, Geographic, and Aboriginal and Torres Strait Islander Inequalities in Diabetic Foot Disease and Diabetes-Related Lower Extremity Amputations

Singh¹

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Effectiveness of bedside investigations to diagnose peripheral artery disease among people with diabetes mellitus: A systematic review

Chuter

Schaper

Mills

et al. 2023

Diabetes Metabolism Res

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As a progressive disease process, early diagnosis and ongoing monitoring and treatment of lower limb peripheral artery disease (PAD) is critical to reduce the risk of diabetes‐related foot ulcer (DFU) development, non‐healing of wounds, infection and amputation, in addition to cardiovascular complications. There are a variety of non‐invasive tests available to diagnose PAD at the bedside, but there is no consensus as to the most diagnostically accurate of these bedside investigations or their reliability for use as a method of ongoing monitoring. Therefore, the aim of this systematic review was to first determine the diagnostic accuracy of non‐invasive bedside tests for identifying PAD compared to an imaging reference test and second to determine the intra‐ and inter‐rater reliability of non‐invasive bedside tests in adults with diabetes. A database search of Medline and Embase was conducted from 1980 to 30 November 2022. Prospective and retrospective investigations of the diagnostic accuracy of bedside testing in people with diabetes using an imaging reference standard and reliability studies of bedside testing techniques conducted in people with diabetes were eligible. Included studies of diagnostic accuracy were required to report adequate data to calculate the positive likelihood ratio (PLR) and negative likelihood ratio (NLR) which were the primary endpoints. The quality appraisal was conducted using the Quality Assessment of Diagnostic Accuracy Studies and Quality Appraisal of Reliability quality appraisal tools. From a total of 8517 abstracts retrieved, 40 studies met the inclusion criteria for the diagnostic accuracy component of the review and seven studies met the inclusion criteria for the reliability component of the review. Most studies investigated the diagnostic accuracy of ankle ‐brachial index (ABI) (N = 38). In people with and without DFU, PLRs ranged from 1.69 to 19.9 and NLRs from 0.29 to 0.84 indicating an ABI <0.9 increases the likelihood of disease (but the extent of the increase ranges from a small to large amount) and an ABI within the normal range (≥0.90 and <1.3) does not exclude PAD. For toe‐brachial index (TBI), a threshold of <0.70 has a moderate ability to rule PAD in and out; however, this is based on limited evidence. Similarly, a small number of studies indicate that one or more monophasic Doppler waveforms in the pedal arteries is associated with the presence of PAD, whereas tri‐ or biphasic waveform suggests that PAD is less likely. Several forms of bedside testing may also be useful as adjunct tests and 7 studies were identified that investigated the reliability of bedside tests including ABI, toe pressure, TBI, transcutaneous oxygen pressure (TcPO2) and pulse palpation. Inter‐rater reliability was poor for pulse palpation and moderate for TcPO2. The ABI, toe pressure and TBI may have good inter‐ and intra‐rater reliability, but margins of error are wide, requiring a large change in the measurement for it to be considered a true change rather than error. There is currently no single bedside test or a combination of bedside tests that has been shown to have superior diagnostic accuracy for PAD in people with diabetes with or without DFU. However, an ABI <0.9 or >1.3, TBI of <0.70, and absent or monophasic pedal Doppler waveforms are useful to identify the presence of disease. The ability of the tests to exclude disease is variable and although reliability may be acceptable, evidence of error in the measurements means test results that are within normal limits should be considered with caution and in the context of other vascular assessment findings (e.g., pedal pulse palpation and clinical signs) and progress of DFU healing.

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Diabetic major amputation in Far North Queensland 1998–2008: What is the Gap for Indigenous patients?

Cited by 27 publications

References 17 publications

Diabetic foot disease in Indigenous people

Diabetic foot disease in Indigenous people

Socio-Economic, Geographic, and Aboriginal and Torres Strait Islander Inequalities in Diabetic Foot Disease and Diabetes-Related Lower Extremity Amputations

Effectiveness of bedside investigations to diagnose peripheral artery disease among people with diabetes mellitus: A systematic review

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